Unlearning 101

Start Treating Employees Like Customers

Here is a novel idea many employers might want to begin implementing: start treating your employees like customers. Why? Because it can save money.

I recently came across this article explaining how Genentech has begun developing apps to help make its sales force more productive. One problem area identified by the company was that sales personnel were often taking more than a week to record their sales call visits to doctors.

As someone who despises paperwork, I can relate to why it might take a salesperson so long to record this information. By making an intuitive, easy-to-use app, however, Genentech alleviated a major hassle for its sales force and, in the process, was able to increase its profits.

The bottomline doesn't always have to only be about the company's bottomline. If more companies would start treating their employees as customers and providing them better tools to do their job they are likely to find that their increased profits more than exceed the cost of developing and implementing many of these new tools.

Dead Men Don't Unlearn

I know a few people who don't wear seat belts. Normally, as someone with libertarian leanings, I wouldn't have a problem with this. (This would almost certainly be the case if society weren't also required to pay for their treatment after they have been in an accident)

My problem stems from those individuals who cite, as a rationale for their decision, stories of people who have lived after being thrown through a windshield. Their conclusion is that a seat belt might somehow similarly prevent them from escaping death after a bad accident. In short, they use the stories of these survivors as justification for their decision.

I will admit that, while rare, such events do occur and people can occasionally be saved by being thrown through a windshield. What my friends who espouse this line of thinking miss is that there are literally thousands of people who died precisely because they were thrown into or through a windshield. 

Dead men don't talk so it is only natural that we will only hear the stories of those rare few who were fortunate enough to survive.

An element of unlearning us to see what we can't see and hear what we can't hear. This is hard to do but if you listen closely you might just hear the lesson of unlearning in the whispers of the thousands who didn't live to tell the tale of their encounter with the windshield.

If I haven't been clear enough, I encourage you to buckle up. If you need a little inspiration, just watch this short but powerful video.

Grow From Your Inexperience

 

 “Human beings, who are almost unique in having the ability to learn from the experiences of others, are also remarkable for their apparent disinclination to do so.” Douglas Adams      

 

Question: Which is the more likely scenario?

 

A)    Roger seemed happily married. He killed his wife.

B) Roger seemed happily married. He killed his wife because he wanted her inheritance.

 

Many people select “B” because it sounds more plausible. But that is the wrong answer. The correct answer is “A” for the simple reason that, logically, the more broadly worded description depicted in Scenario A not only includes Scenario B but also every other possible reason why Roger might have killed his wife, including reasons of anger, jealousy, mental illness, or accident.

 

The relevance of this common mistake on focusing on the specific to the exclusion of the general can be found in how many people think about insurance. After 9-11, many people were more likely to buy insurance to protect against acts of terrorism even though injury or death due to terrorism is already covered under the general terms of plain insurance plans. Rental car companies also play off peoples’ inexperience when they encourage them to buy “extra” insurance. They know it is easier for people to imagine the specific experience of getting into an automobile accident in a new city with a rental car and they use this knowledge to get the customer to purchase additional – and unnecessary -- insurance.

 

It is not sufficient, however, to merely get others to stop profiting from our inexperience; there are additional ways to profit from your own inexperience – provided you’re willing to unlearn.

 

In many cases, we can learn from those who have experienced something we have not. This, unfortunately, is harder to do than it might sound because people don’t like to believe they are “average” and are, therefore, likely to experience the same thing that those who have actually had experience.

 

In his book, Stumbling Upon Happiness, Dan Gilbert demonstrates how people who win the lottery are not happier a year after winning the lottery. Nevertheless, the overwhelming majority of lottery players are convinced that they are unique (or “not average”) and, unlike those other poor saps who won the lottery, winning will make them happy. This illusion keeps them playing (and, for the most part, losing) even though it could be avoided by applying other peoples’ real-world experiences to their hypothetical future experience.

 

The second way to unlearn from our experiences is to become cognizant of the fact that often our most vivid memories come from the most unlikely experiences. This causes us to believe that these unlikely experiences are more common than they actually are. For example, do you “always” get in the slowest lane at the grocery store or on the highway? The reality is that you don’t. You just don’t recall the many times your lanes moves at a normal clip.

 

The same effect is at work when people refuse to fly in an airplane after a bad plane crash. Airline accidents are exceedingly rare and, statistically speaking; it is far more dangerous to drive than fly. But because people can more easily and vividly recall these unlikely plane crashes, they are more likely to select a different – and far more dangerous – mode of transportation.

 

By reminding yourself of the totality of your – and others -- experiences, however, not only can you gain a clearer picture of reality, you might even grow enough from your inexperience to extend your life.

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See What Isn't There

Unlearning the Doctor-Patient Relationship

I recently wrote an article entitled "Social Networking: The Future of Health Care" for United Advantage-- United Healthcare's quarterly newsletter. As a result, I have been invited by another large health insurer to come in and speak about how social networking will effect their industry.

I have a great deal to say about the topic, but one of the most important things I intend to tell the company's executives is that social networking will profoundly change the nature of the doctor-patient relationship.

It is already well documented that many patients are becoming better informed prior to visiting their providers. Nevertheless, as the amount of medical information continues to proliferate (which will lessen the doctor's status as the "expert" because they will be unable to stay abreast of all of the latest findings and research) and as patient networks -- such as PatientsLikeMe -- become stronger; the relationship between the doctor and the patient is going to become more balanced. To be successful, the provider must recognize the client more as a partner and less as a patient. To be successful in the future, providers must unlearn the old way of doing business which, in many cases, placed the doctor on a pedestal.

To continue to be a valuable resource to the patient, providers must engage their own social networks to query other providers who can help diagnose and offer potential treatments. The net effect is that more diagnoses and treatments and will be "crowd-sourced" in the future. This may be threatening to many doctors and specialists but if they really want to help their patients they have to check their ego at the door.

 

Lastly, providers and patients alike need to understand that social networking will not only open up better and stronger lines of communications, new social networking sites can be used in innovative ways to engage patients in healthier and more enjoyable treatments. For example, think of patients at risk of diabetes engaging other at-risk patients in their neighborhood to form walking or exercise clubs.

The future is evolving fast. As I have said before -- and will say again -- to first survive and then thrive, it will be essential to unlearn.

 

Related Posts

 

Is the Health Care Industry Prepared to Unlearn?

Unlearning Small Changes

Read the following sentence: A woman without her man is nothing. My guess is that if you're a woman it pissed you off because you read it in the following way: "A woman, without her man, is nothing". If, however, you made just a small change in punctuation it could be read this way: "A woman: without her, man is nothing."

My point is this: Sometimes a small change can have a huge impact. In the above case, the meaning was fundamentally altered.

Now consider the issue of organ donations. It is estimated that in America over 90,000 people are currently on waiting lists. Many of those individuals will, unfortunately, die on a waiting list due to a shortage of available organ donors.

It need not be this way. In Germany, only 12% of the population has agreed to donate an organ (in the event they die unexpectedly). In Austria, the percentage is a staggering 99%. The difference? In Germany, people must explicitly give their consent to donate an organ by opting in on a state-provided form. In Austria, people must explicitly opt out. In other words, in Austria, people are assumed to consent to organ donation but are free to opt out if they are uncomfortable with the idea.

In a perfect world, it shouldn't matter what wording the state puts on a form. If people want to donate an organ they are free to do so under either policy. Austria, though, has learned that a small change in language can lead to a huge change -- one which saves many lives.

If other states and countries want to do the same maybe they should start by unlearning their "opt in" clauses.

Unlearning Knee, Back and Spinal Surgery

"It is difficult to get a man to understand something when his salary depends on not understanding it." Upton Sinclair

I really enjoy the above quote because there is so much truth to it. I was especially reminded of the quote after reading this article about the efficacy of spinal surgery in today's Wall Street Journal. 

According to the article (and based upon research published in the New England Journal of Medicine) a popular surgery designed to repair fractured bones in the spine was found to deliver no detectable benefit when compared with a placebo procedure.

This is not an inconsequential finding because an estimated 100,000 people had the surgery last year at an estimated cost of between $2,000-$5,000.

Not surprisingly, members of the Society of Interventional Radiology (whose members perform the surgery), have taken issue with the study. According to one doctor who performs the technique the study must be wrong because "We take a patient who's been lying in bed in a hospital, bedridden, you do the procedure and they're home the next day."

The response mirrors almost identically the response to a 1994 study in the New Journal of Medicine chronicling the ineffectiveness of MRI's for spinal injury (documented in the book, How We Decide, Pp. 160-165) as well as a 2002 study in the New England Journal of Medicine documenting the ineffectiveness of arthroscopic surgery. (This case is highlighted in the book, Predictably Irrational.)

In both cases, doctors who had performing surgeries simply could not believe the procedures they had been conducting for years -- often at great expense -- were no more effective than placebo procedures. In response, they either attacked the methodology of the study or highlighted cases of individual patients who benefited from the surgery.

It is not that the doctors are unintelligent, uncaring or greedy; rather when confronted with information that contradicts what they think they know it is easier to avoid the truth -- by either questioning the study or offering antidotes -- than it is to unlearn. (This is especially so when their salaries are highly dependent upon said procedure.)

But my advice is this: If the doctors won't unlearn then it is incumbent upon you to unlearn. Next time you need an MRI (for a spinal injury); arthroscopic surgery for your knee; or have a fractured bone in your spine, get a second and, if necessary, a third opinion before proceeding!

Unlearning Prediction

"Those who have knowledge, don’t predict. Those who predict, don’t have knowledge.” Lao Tzu

This famous quote was uttered over 2500 years ago and may strike some people as odd that, as a professional futurist, I have chosen to highlight it.

My rationale is two-fold. First, as I have said many times before, the chief responsibility of a futurist is not to “predict” the future but rather outline a range of future possibilities. Second, and more important, I have highlighted the quote because it is true.

If you have not already read Nassim Taleb's outstanding book, The Black Swan: The Impact of the Highly Improbable, do so as soon as possible. On Page 177 of the book, Taleb has an illustration of the scattering effect which artfully explains why predicting the future—especially for longer time frames—is virtually impossible.

Because I can’t reprint the figure here, I am left with Taleb’s analogy for understanding the scattering effect: the prediction of a billiard ball.

Assuming one has knowledge of the location of every ball and the speed and accuracy of the cue ball, it is relatively easy to predict the movement of the ball after the first shot. A person might even expect that, due to the growing computational power of computers, the second, third and fourth degree movements can be estimated with great accuracy. The problem, however, grows increasingly complex with each subsequent movement and after the ninth movement the gravitational pull of a person standing at the next pool table exerts enough of an effect to alter the trajectory of the ball. And after 56 movements even the smallest particle on the outer edge of the universe will effect the trajectory!

The bottom line is this: There are simply too many factors to consider when contemplating the future 20, 30, 50 or 100 years out. (Even a small effect today can have outsized implications 50 years hence). The situation, of course, becomes even more complicated because of Taleb’s main thesis which is that “Black Swans”—described as “high impact, low probability” events—tend to shape the future more than “expected” trends.

Therefore, whether a future “Black Swan” takes the shape of a pandemic, an asteroid, an E-bomb, a rogue terrorist attack, a North Korean or Iranian nuclear attack, an unexpected breakthrough in quantum computing or synthetic biology, or, more likely, some “unknown unknown;” the future will be difficult too predict because we don’t have—and won’t ever have—enough knowledge about the future.

Unlearning Disease

With all of the information now pulsing around us, it is easy to forget that “we don’t know what we don’t know.” I constantly try to remind my clients in the health care sector of this simple fact. A case-in-point is the extraordinary strides being made in the field of genomics—which, due to accelerating gene sequencing technologies, are occurring on a daily basis.

One the bigger implications of these cascading discoveries is that they will likely fundamentally alter how we classify disease in the future. As a little historical reference, it is useful to consider that in 1850 there were only 140 categories of disease. In 1993, the last time the World Health Organization undertook the classification of all diseases, there were some 12,000. The next classification isn’t expected to occur until 2015, but it is not hard to imagine that the number of diseases—and how they will be classified—will increase even more.

For a great primer on this possibility, I’d encourage you to read this article, Redefining Disease, Genes and All. I especially liked this quote at the end of the article. One doctor, responding to the fact that as late as 1909 one of the leading causes of death was listed as “visitation of God,” went on to offer this warning: “Imagine how they are going to to be laughing at us,” he said, “not 100 years from now, but even 50 or 20 years now.”

As a result of accelerating technological change, it is certain that “we don’t know what we don’t know” about a wide variety of diseases. To stay open to the possibility that these diseases might soon be both classified and treated differently , it is helpful to keep in mind the possibility that if you don’t change your views you will likely be widely mocked at some point in the future—and it might even be sooner than you expect.

Interested in viewing related articles on unlearning? Check out these past articles:

Does the Pharmaceutical Industry Need to Unlearn?
Is the Health Care Industry prepared to Unlearn?

A Lesson in Unlearning from Peter Bernstein

"We simply do not know what the future holds." -- Peter Bernstein

Peter Bernstein, a best-selling author and risk management pioneer, passed away earlier this month. On Saturday, the Wall Street Journal ran a nice remembrance. I especially liked the final paragraph which read:

"Asked in 2004 to name the most important lesson he had to unlearn, he said: "That I knew what the future held, that you can figure this thing out. I've become increasingly humble about it over time and comfortable with that. You have to understand that being wrong is part of the [investing] process."

It is a wonderful reminder to both unlearning -- and to the importance of having some intellectual humility.

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Insuring the Future

Unlearn the Future, Today

Effective today, June 8, 2009, General Motors and Citigroup are no longer components of the Dow 30. In and of itself this news has no great relevance, but it does highlight how fast today’s economy continues to change. As I mentioned the other day on my other blog (www.jumpthecurve.net), many people think that "tomorrow will be pretty much like yesterday.” This simply isn’t true.

One strategy I have advocated for unlearning the future is to "develop a future bias.” As a thought exercise and to help you unlearn, I’d like to suggest a second exercise: review the members of the current Dow 30 and imagine which company will be the next to be removed from the list and explain why it might go. (For extra credit, I invite you to imagine which company might replace it.) The purpose of this exercise is to force you what of your comfort zone and come face-to-face with the reality that “the only constant is change” and unlearning is a critical skill for the future. (Also see "The Future Requires Unlearning.)

To help you get started, here are some possibilities. Advances in nanotechnology could cause many of the materials Alcoa makes to become either irrelevant or obsolete, and the company will be replaced by a nanomaterial company. Or perhaps Caterpillar will not remain competitive due to advances in robotics and it will be replaced by iRobot. A third alternative is that intense competition from Nokia will wreak havoc on both AT&T and Verizon and they will be replaced on the Dow 30 by Google, which may continue to make strides in the communication field with its new Android platform. A fourth possibility is that new advances in biotechnology will render many existing drugs obsolete and Pfizer will be replaced on the Dow 30 with a biotech company such as Genentech.

Really, there is no shortage of possibilities but one of the best ways to prepare for the future is to simply acknowledge that it is going to change. And, as Darwin said: “It is not the strongest of a species that survives, nor is it the fittest; it is those that can adapt the fastest.” Are you and your organization prepared to adapt -- and unlearn? Quickly?

If not, you could go the way of General Motors.

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